| NPI | 1174911960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 883167) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-149222) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2016-09-08 |